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The bumpy road to imaging access in rural America

by John R. Fischer, Senior Reporter | June 18, 2018
Mobile Imaging
From the June 2018 issue of HealthCare Business News magazine

Despite the hurdles involved, some mobile imaging providers, like Insight Imaging and Shared Imaging, are successfully deploying mobile PET/CT units to providers.

“With PET/CT, the whole scheduling process involves calling the patient the night before, giving them instructions, such as not to eat after this time frame or to be here this early,” said Steve Richter, senior vice president and general manager of Insight Imaging’s mobile division. “It’s a lot different from an MR because there’s an injection involved; there’s a time and weight for the uptake of the pharmaceutical into the anatomy and the scan itself; and there’s a lot more coordination required between our schedulers, pharmacies, and our clinical nursing staff.”

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The magnet room on an Insight Imaging MR mobile unit.
Breast MR is also a challenge for rural providers, requiring specific software updates and hardware. The cost of this equipment is often too much for hospitals in rural areas to afford.

Even mobile coaches for these exams require specific coils and breast software to ensure high quality images are produced, meaning the hospital cannot perform the procedure if there is no mobile provider in the area equipped with these coaches or parts.

“A lot of accounts typically don’t do a lot with women’s health but some that we go to have a very large women’s health population so they need breast software and breast coils,” said Richter. “It’s the same with prostate. They’re going to want some specialized software and coils for that to accommodate their patients.”

Getting squeezed by the bigger compliance and reimbursement picture
Compliance is also an issue for mobile CTs depending on how long a facility uses one. Those that are long-term must, at minimum, hold XR-29 compliance, which requires scanners to be equipped with DICOM Structured Reporting to log a patient’s dose history in records; built-in adult and pediatric protocols; a MITA dose check function to notify when dose thresholds have been exceeded; and automatic exposure control for real-time radiation dosage.

“You can’t have a CT for three years on a three year lease and have it be exempt from XR-29 compliance,” said Steve Pennington, sales manager of Oxford Instruments Healthcare. “That is considered essentially a part of the hospital, as opposed to a unit that’s only there for something like a period of construction. In those situations, you may not have to have the same level of compliance.”

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